Why Employer-Based Health Insurance Doesn't Cut It

By Molly M. Ginty, Women's eNews. Posted January 14, 2009.

On Dec. 22, the Washington-based Progressive Democrats of America mobilized thousands to phone their congressional representatives and lobby for Conyers' bill. A second call-in day is set for Jan. 15.

Single-payer advocates say the current system is not only costly, but in crisis. More than 100,000 Americans die each year of treatable conditions because they are uninsured, underinsured or fall prey to health-care bureaucracy, according to a January 2008 study in the journal Health Affairs. "Such deaths account, on average, for 23 percent of total mortality under age 75 among males and 32 percent among females," noted the authors, who ranked the United States last among 19 industrialized nations in terms of preventable deaths.

Eighteen percent of women under 65 are uninsured -- largely due to financial constraints -- and since 2000, the cost of health premiums has increased six times faster than the median income, reports the Kaiser Family Foundation, in Menlo Park, Calif.

Linda Prine, a family physician in New York City, says she's seen women wait four months for Pap smears, be denied the prescriptions they need and die of treatable diseases because they can't afford adequate health care.

'Bureaucracy Threatens Lives'

"The current American health care system is plagued by so much bureaucracy that it's a threat to patients' lives," says Prine. "That's why I've joined the push to urge Obama to replace this system with a single-payer one, which would offer affordable, continuous, universal care."

Prine says her practice deals with 52 different health care plans. "All have different payment schemes and paperwork. But under a single-paper system, this bureaucracy would be replaced by a streamlined electronic medical records system."

Instead of a patchwork of private insurance companies that functions as a market-based regulator of costs, covered services and providers, the single-payer system has a public or quasi-public agency pay medical providers. Costs are controlled through bulk purchasing, negotiated fees with suppliers and service providers, and global budgeting, which pays providers from a pooled budget versus a system of itemized, one-by-one claims.

The mixed system of private and public medicine in the United States spends $7,026 per person on health care annually, while countries with single-payer systems spend an average $3,840, reports the Paris-based Organization for Economic Cooperation and Development. A single-payer system would save $350 billion in annual paperwork, enough savings to provide care to all without costing more, reports Physicians for a National Health Program.

"With private insurance, rather than send a patient with chronic alcoholism and liver disease to the detox program where she could get the best care, I have to send her wherever her insurance company dictates she should go, even if it's not to a qualified specialist," says Claudia M. Fegan, a physician in Chicago. "In a single-payer system, I could offer her the treatment she really needs."

Under Medicare, a single-payer system is already in place for U.S. citizens who are over age 65 or who have permanent disabilities. The Medicare program spends 3 percent of its revenue on administrative costs, while private insurers spend 30 percent or 10 times as much, according to the Chicago-based American Medical Association and the New England Journal of Medicine.

"Health insurance costs the average family $8,000 to $10,000 annually, minus co-pays and the cost of drugs," says Jenkins of the California Nurses Association, referring to households that either receive employer-based benefits or pay for their own insurance. "But single-payer insurance would likely cost them less than this in taxes each year."

Copyright 2009, Women's eNews. All rights reserved.

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Molly M. Ginty is a freelance writer based in New York.

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